通窍活血汤结合丁苯酞治疗内囊预警综合征疗效研究

Effect of Tongqiao Huoxue decoction combined with butylphthalide in treating capsular warning syndrome

目的:分析通窍活血汤结合丁苯酞治疗内囊预警综合征的疗效及预后情况。方法:将130例内囊预警综合征患者采用随机数字表法分为对照组(65例)和观察组(65例)。两组均给予常规治疗,在此基础上,对照组采用丁苯酞治疗,在对照组的基础上,观察组采用通窍活血汤治疗,两组均治疗1个月,随访2个月。统计两组治疗1个月后的疗效,比较两组治疗前和治疗1个月后主要症状积分、血管内皮功能、大脑中动脉血流及治疗前与治疗2周、1个月后及随访2个月后神经功能恢复情况。结果:治疗1个月后,观察组总有效率高于对照组(P<0.05)。治疗1个月后与治疗前比较,两组一过性视岐昏瞀、一过性言语謇涩、阵发性偏身麻木、短暂性偏身瘫软评分及血清血栓素B_(2)(TXB_(2))、内皮素(ET)水平降低,观察组低于对照组(P<0.05);两组血清一氧化氮(NO)水平、平均血流速度(V_(mean))、最小血流速度(V_(min))、最大血流速度(V_(max))、平均血流量(Q_(mean))升高,观察组高于对照组(P<0.05)。治疗2周、1个月后及随访2个月后比较,两组改良Rankin量表(MRS)评分呈降低趋势,观察组MRS评分低于对照组(P<0.05)。结论:通窍活血汤结合丁苯酞治疗内囊预警综合征患者,可有效改善患者主要症状、血管内皮功能、大脑中动脉血流,促进患者神经功能恢复,有助于患者预后改善,具有较好的治疗效果。

Objective:To analyze the curative effect and prognosis of Tongqiao Huoxue decoction combined with butylphthalide in treating capsular warning syndrome.Methods:130 patients with capsular warning syndrome were randomly divided into the control group(65 cases)and the observation group(65 cases)by random number table method.Both groups were given routine treatment.On this basis,the control group was treated with butylphthalide,and the observation group was treated with Tongqiao Huoxue decoction on the basis of the control group.Both groups were treated for 1 month and followed up for 2 months.The curative effect of the two groups after 1 month of treatment was counted,and the main symptom scores,vascular endothelial function,blood flow of middle cerebral artery and the recovery of neurological function before and after 2 weeks,1 month and 2 months of follow-up were compared between the two groups.Results:After 1 month of treatment,the total effective rate of the observation group was higher than that in the control group(P<0.05).After 1 month of treatment,compared with before treatment,the scores of transient vertigo,transient dysphoria,paroxysmal hemiparalysis,transient hemiparalysis and serum levels of thromboxane B_(2)(TXB_(2))and endothelin(ET)of the two groups decreased,and the observation group was lower than those in the control group(P<0.05);the levels of serum nitric oxide(NO),average blood flow velocity(Vmean),minimum blood flow velocity(Vmin),maximum blood flow velocity(Vmax)and average blood flow(Qmean)of the two groups increased,and the observation group was higher than those in the control group(P<0.05).After 2 weeks,1 month and 2 months of follow-up,the score of improved rankin scale(MRS)of the two groups showed a decreasing trend.After 2 weeks,1 month and 2 months of follow-up,the score of MRS of the observation group were lower than those in the control group(P<0.05).Conclusion:Tongqiao Huoxue decoction combined with butylphthalide can effectively improve the main symptoms,vascular endothelial function,blood flow of middle cerebral artery,and promote the recovery of nerve function in patients with capsular warning syndrome,and help patients’prognosis.